by Beth Ayers, Family Support Training Coordinator
August 26, 2025
I attended a Children’s Special Health Services (CSHS) stakeholder meeting recently to help inform a needs assessment for Montana. One area the needs assessment will focus on is bullying among children and youth with special healthcare needs. The needs assessment will look at the prevalence of bullying and the available supports, or lack of, for families.
Bullying remains one of the most persistent issues affecting children and adolescents, often leading to devastating consequences. Among the most vulnerable populations are children with special healthcare needs and mental health conditions. These children are disproportionately targeted due to their perceived differences, and they frequently lack the resources or support systems to defend themselves or seek help.
The
Health Resources and Services Administration (HRSA) defines Children and Youth with Special Health Care Needs (CYSHCN) as individuals from birth to age 21 who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally. These conditions include, but are not limited to, autism spectrum disorder (ASD), Down syndrome, attention-deficit/hyperactivity disorder (ADHD), learning disabilities, and physical disabilities. Childhood mental health conditions include anxiety disorders, depression, bipolar disorder, and behavioral disorders, among others. Children with these conditions often struggle with communication, social interaction, and behavioral regulation—areas crucial for peer relationships. These challenges make them more visible targets for bullying and less able to seek help or protect themselves (Rose et al., 2011).
Research consistently shows that children with special healthcare needs and mental health conditions are at a higher risk of being bullied. According to the National Center for Education Statistics (NCES, 2019), students with disabilities are more than twice as likely to be bullied compared to their peers without disabilities. Children with autism, ADHD, or emotional and behavioral disorders face especially high rates of verbal taunts, physical aggression, and social exclusion (Zablotsky et al., 2014). These elevated risks stem from both their social vulnerabilities and the frequent lack of understanding and empathy by other children.
There are various forms of bullying. Children with special healthcare needs and mental health conditions may experience verbal bullying (name-calling, mocking, and teasing), physical bullying (hitting, pushing, or property damage), social or relational bullying (exclusion from social groups or spreading rumors), and cyberbullying (harassment through social media or other digital platforms) (Kowalski et al., 2014). Because these children are often socially isolated or misunderstood, the bullying they experience tends to be more persistent and more damaging.
The emotional and psychological consequences of bullying are severe and often more pronounced in children with special healthcare needs or mental health conditions. Many already struggle with self-regulation, emotional sensitivity, and confidence. Bullying exacerbates these issues, contributing to increased anxiety and depression (Twyman et al., 2010), poor academic performance and school avoidance (Rose et al., 2011), social withdrawal and distrust of peers, and suicidal ideation and self-harm (Bauman et al., 2013). Long-term consequences may include chronic mental health problems, difficulty forming relationships, and reduced educational and occupational success. Bullying also negatively impacts the child’s ability to learn. According to the National Bullying Prevention Center, children with special healthcare needs or mental health conditions who are bullied can experience school avoidance and higher rates of absenteeism, lower grades, inability to concentrate, loss of interest in academic achievement, and increase in dropout rates.
Addressing bullying among this population is complex. Many children with communication or developmental challenges struggle to describe or report bullying incidents. In some cases, their behaviors are misinterpreted, and the bullying goes unnoticed or ignored. Educators may lack adequate training to recognize bullying against children with special healthcare needs or may view such incidents as peer conflict rather than targeted abuse (Harcourt et al., 2014). When children with disabilities retaliate or exhibit aggressive behavior as a coping mechanism, they may be incorrectly labeled as the aggressors.
Integrated educational settings where students with and without disabilities are educated together has the potential to reduce bullying by fostering empathy and understanding. However, inadequate supports may increase exposure to bullying (Carter & Spencer, 2006). Schools can address bullying by implementing disability awareness programs, providing social-emotional learning (SEL), and ensuring all staff are trained to manage diverse classroom needs compassionately. Parents play an important role by being actively involved in planning and advocating for their child’s emotional safety at school. The National Bullying Prevention Center’s website has information and resources on bullying including a bullying prevention model for students with disabilities called peer advocacy. The website explains, “Peer advocacy is a program centered around inclusion and designed to educate students on speaking out on behalf of students with intellectual, developmental, or other disabilities. It is a unique approach that empowers students to protect those targeted by bullying and to provide social inclusion opportunities.”
Another way to address bullying is by participating in Let’s Talk About Bullying and Disability. The National Bullying and Prevention Center website states, “Students with disabilities and those who support them are invited to share how they view the intersection between bullying and disability. The idea is for students with disabilities, peers, parents and siblings, school staff and others—using the medium of their choice, such as video, art, or written or spoken word—to respond to the question, “what do you want everyone to know about bullying and disability?” Submissions will be used to elevate awareness and conversation through posting on NBPC websites, social media, and other networks.” Go to
https://www.pacer.org/bullying/info/students-with-disabilities/ and click the tab “Bullying and Disability” to share your submission.
Children with disabilities are also legally protected from discrimination and harassment under federal U.S. laws. The Individuals with Disabilities Education Act (IDEA), Section 504 of the Rehabilitation Act, and the Americans with Disabilities Act (ADA) require schools to ensure a safe learning environment and address bullying that interferes with a child’s education (U.S. Department of Education, 2013). Failure to act on bullying may constitute a violation of these laws. Schools can be held legally accountable if they neglect to provide appropriate accommodations or fail to prevent a hostile environment.
Parents looking for help regarding bullying can find resources at StopBullying.Gov. All children deserve to grow, learn, and thrive in a safe and respectful environment regardless of ability or diagnosis.
Resources and References:
StopBullying.Gov
National Bullying Prevention Center
Bauman, S., Toomey, R. B., & Walker, J. L. (2013). Associations among bullying, cyberbullying, and suicide in high school students.
Journal of Adolescence, 36(2), 341–350.
https://doi.org/10.1016/j.adolescence.2012.12.001
Carter, B. B., & Spencer, V. G. (2006). The fear factor: Bullying and students with disabilities.
International Journal of Special Education, 21(1), 11–23.
Harcourt, S., Jasperse, M., & Green, V. A. (2014). ‘We were sad and we were angry’: A systematic review of parents’ perspectives on bullying of their children with autism spectrum disorder.
Research in Autism Spectrum Disorders, 8(3), 292–304.
https://doi.org/10.1016/j.rasd.2013.12.005
Kowalski, R. M., Giumetti, G. W., Schroeder, A. N., & Lattanner, M. R. (2014). Bullying in the digital age: A critical review and meta-analysis of cyberbullying research among youth.
Psychological Bulletin, 140(4), 1073–1137.
https://doi.org/10.1037/a0035618
National Center for Education Statistics. (2019).
Students’ reports of bullying: Results from the 2017 School Crime Supplement to the National Crime Victimization Survey.
https://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2019054
Pacer Center. (2020).
Bullying prevention for children with disabilities.
https://www.pacer.org/bullying/
Rose, C. A., Espelage, D. L., & Monda-Amaya, L. E. (2011). Bullying and victimization among students in special education and general education curricula.
Exceptional Children, 77(4), 461–474.
Twyman, K. A., Saylor, C. F., Taylor, L. A., & Comeaux, C. (2010). Comparing children and adolescents engaged in cyberbullying to matched peers.
Cyberpsychology, Behavior, and Social Networking, 13(2), 195–199.
https://doi.org/10.1089/cyber.2009.0137
U.S. Department of Education. (2013).
Dear Colleague Letter on Bullying of Students with Disabilities.
https://www2.ed.gov/about/offices/list/ocr/letters/colleague-201310.html
Zablotsky, B., Bradshaw, C. P., Anderson, C. M., & Law, P. (2014). Risk factors for bullying among children with autism spectrum disorders.
Autism, 18(4), 419–427.
https://doi.org/10.1177/1362361313477920
Edited and researched with ChatGPT
